Prostate gland enlargement occurs in men as they age and is quite common in men above the age of 50. Medically referred to as benign prostatic hyperplasia (BPH), the condition can be completely benign or have serious complications such as bladder blockage, urinary retention, bladder infections, kidney stones or kidney damage. Since the prostate gland is located underneath the bladder, its increased size can block the flow of urine through the urethra, a tube that carries urine from the bladder out of the body via the penis. This in turn results in problems with urination and other complications.
Benign prostate enlargement (BPH) is not prostate cancer.
Even though the complications of an enlarged prostate may be serious, BPH is not prostate cancer. Neither does it imply you have a greater risk of getting prostate cancer. Usually, the growth of prostate tissue associated with BPH starts around the inner prostate (a ring of tissue around the urethra) and progresses inward. In contrast to this, prostate cancer often grows from the outer part of the prostate and continues outward. Therefore, having an enlarged prostate does not increase your risk of prostate cancer because the two conditions typically begin in different areas of the prostate. Nevertheless, men can have prostate cancer and enlarged prostate at the same time, so you should speak with your urologist or GP if you have any concerns about prostate cancer. Keep in mind that BPH does not cause erection problems and does not affect a man’s capacity to father children.
What causes BPH?
Generally, an enlarged prostate is considered a normal part of the aging process in men, believed to result from changes in hormone levels and cell growth. And while the actual cause of benign prostate enlargement is still unknown, studies have shown that changes in the cells of the testicles play a role in the growth of the gland. This is confirmed by the fact that men whose testicles are removed at a young age never develop the condition while those whose testicles are removed after developing BPH experience shrinkage in the size of the prostate. Some studies have also revealed that men with obesity or diabetes, as well as men with a father or brother with the condition, are more likely to develop BPH.
What are the 4 common symptoms of an enlarged prostate?
One of the more common symptoms of BPH is a frequent or urgent need to urinate. Men with BPH will have the urge to urinate more often and particularly at night, a condition known as nocturia. By frequent urination, we mean having to pass urine eight or more times a day. The need to urinate will be urgent because the increased pressure placed on the bladder and urethra by the enlarged prostate make holding urine more difficult.
On the other hand, urinating can be made more difficult by BPH because the increased pressure on the urethra may block urine flow from the bladder out through the penis. You may find it hard to start a urine stream or experience an interrupted or weak urine stream. Depending on the severity of your BPH, you may find it difficult to pass urine, a condition resulting in urine retention. When this happens, you must see your doctor immediately so that a catheter can be inserted into your bladder to drain the urine. Your doctor may recommend you see a urologist for surgery to remove a portion of the enlarged prostate tissue or make cuts on the prostate in order to widen the urethra.
Another symptom is pain during urination or ejaculation caused by pressure on the urinary tract or reproductive system due to BPH. In fact, some men even feel the need to push out urine, which may also cause pain. Remember, pain during ejaculation or urination may also be due to infection.
Other problems associated with an enlarged prostate include urinary tract infections, unusual urine color or smell, blood in urine, bladder stones, and bladder or kidney damage. But not all men with BPH show these symptoms. In fact, some men with enlarged prostate do not get any symptoms at all. If you do have symptoms, you should definitely see your doctor.
How is an enlarged prostate treated?
Your urologist will ask you questions about your symptoms and about your past health. A physical exam, a urine test (urinalysis) and a digital rectal examination will also be performed to aid diagnosis. In some cases, your doctor will request the prostate-specific antigen (PSA) test in order to rule out prostate cancer.
If you only have mild to moderate symptoms, your doctor can recommend “watchful waiting” for lifestyle changes and regular check-ups to monitor symptoms. Your doctor may also prescribe medications such as alpha-blockers or 5-alpha-reductase inhibitors to alleviate the symptoms.
If your condition does not improve after trying recommended lifestyle changes and medications, your doctor may opt for surgery. The type of surgery chosen by the urologist will depend on the size of your prostate, any other medical problems you have and the potential risks and benefits of the operation. For more information about treatments for enlarged prostate, visit an Advanced Urology Institute clinic near you.